Sunday, 22 July 2012

PAIN RELIEF IN LABOUR

Pain Relief in Labour

Many women wonder how they will cope with the pain of labour and childbirth. Therefore it is important to become familiar with the options available to you. All hospital units differ slightly and some options are not available in birth centres or if you have chosen to have your baby at home. You should discuss these options with your midwife when you attend ante natal appointments.

It is important to know that many women have a latent phase of labour that can last for many hours or even days. The best way to cope with this stage is to stay as mobile as possible, have regular paracetamol, warm baths and back massages from your partner. You may also choose to use a TENS machine at this stage which you can buy or hire.

It is also important that you learn about breathing and relaxation methods, as these are beneficial throughout your labour and can usually be discussed at your local ante natal classes.

Options which may be available in your area include;

1. Breathing and relaxation.

This puts you in a relaxed state and should help you cope better with the labour. It is good because you are in control and it does not affect the baby. You may also decide on other options at any stage if you feel you aren't coping. Find out from your midwife if there are any classes in your area.

2. Self-hypnosis.

Again, this helps the body to relax for the impending labour although it doesn't work for all women yet some women swear by it. Again, other options can be used alongside it.

3. Complimentary therapies ie aromatherapy.

Different aromatherapy oils are used in several different ways. You can have a few drops added to a warm bath or in a diffuser in the labour room. This method also does not affect the baby and can be used in conjunction with other pain methods. It is important that only certain approved oils are used in pregnancy and only midwives qualified in using this treatment can prescribe it but most units now offer this service.

4. Mobilisation.

This is especially good when in the latent phase or if baby is in the back-to-back position. An exercise ball is excellent in easing lower back pain whilst encouraging your baby to rotate and descend ready for the birth. Most units have these balls readily available but you could always check with your midwife. If you already have one, take it into hospital with you!

5. Waterbirths.

These are increasing in popularity ensuring that most units now offer this service. You can also hire one if you are having a home birth. If you are low risk and you baby doesn't require monitoring, then this is an excellent way to labour and give birth if you should so choose. You can even use Entonox while in the birth pool, although it goes without saying that you can't wear your TENS machine! The downside to this is that the pool may be in use when you attend the hospital.

6. TENS machine (Transcutaneous Electrical Nerve Stimulation).

This is a small machine that is attached to your back and sends out tiny electrical pulses to block pain signals sent from your body to your brain. This machine can also induce your own pain relieving endorphins to kick in.

The TENS machine does not affect your baby, it is portable and you control it yourself. You can also opt for other analgesics in conjunction with this. Some women do not find it effective enough to be their only choice but others find it extremely effective during the early stages. You can buy your own machine or hire one for several weeks when you can practice using it - although it's important that you don't use it until you are 37 weeks pregnant.

7. Entonox (gas and air).

This is many women's preferred choice. You are in control and breathe it in via a face mask or a mouth piece during each contraction. It contains 50% oxygen and 50% nitrous oxide or laughing gas as it's more commonly known. It does not take away all the pain and can occasionally make you feel sick when you first start to use it but it is effective if used correctly. Your midwife will give full instructions on it's use.

8. Diamorphine or Pethedine.

These are drugs that are given by injection into your leg or bottom. They are strong painkillers that come from the opiate group.They help you to relax and cope with the contractions and often help women to sleep intermittently. They are often given with an anti-emetic as they can cause nausea and aren't usually given when the birth is imminent as they cross the placenta to the baby and can cause your baby's breathing to be slow, requiring oxygen and stimulation to be given at the delivery. Your midwife will inform you of any advantages and disadvantages that the drug used at your unit may have.

9. Epidural.This is a fine tube that is inserted into your back by the anaesthetist. A drip or injection is then fed into the tissue close to your spine to block the pain messages to the brain.

You will also need a drip into the back of your hand with fluids infusing as epidurals can cause your blood pressure to fall. You may also not have any feeling in your bladder therefore your midwife will have to insert a catheter at regular intervals during your labour. You will be less mobile and you can only have this option in hospital. It can also slow down your contractions so another drug called syntocinon may have to be commenced via another drip to regulate the contractions again. A disadvantage of having an epidural is a risk of a dural tap which causes a severe headache although this is rare, and can be treated be the anaesthetist.

Although it has no adverse affects on the baby, it is important to know that it can increase the risk of ventouse and forcep deliveries. It is also important to be aware that the anaesthetist may be busy elsewhere in the unit or even siting an epidural on another lady on the labour ward.

If you have any questions relating to this blog or any of my previous blogs please see my new "live chat feature" on the Just Bambinos website: www.justbambinos.co.uk